The liver has two lobes right and the left. liver Metabolizes and detoxifies chemicals drugs. liver secretes a juice called bile, Which will end up in the intestines. It also secrets proteins which are important for blood clotting and other functions.
Liver transplant is the replacement of diseased liver with the healthy liver. Liver transplantation can be done from a blood-related person or recently deceased donors.Liver Transplant is otherwise called as a Hepatic transplant.
End-stage liver disease and acute liver failure can cause by the treatment of liver transplant. Orthotopic transplantation is a common technique for a liver transplant, in which the diseased liver is removed and replaced by the donor Liver in the same position as the original liver. The procedure for surgical is complex, requiring more careful harvest of the donor organ. Liver transplant is only performed at medical centres by highly trained transplant physicians and supporting medical team and it highly regulated. The duration of surgery ranges from 4 to 18 hours depending on patient
Types of liver transplant
There are three different types of liver transplant. They are
- A living donor transplant
- A split type of liver transplant
- Orthotopic transplant from a recently deceased donor
Living donor liver transplantation (LDLT)
Living donor liver transplant means donor by living person. The donor has the operation first in which the surgeon removes either the right or left side of their liver.
Right lobe transplants are generally recommended for adults while left lobes are used In children. This is due to the fact the right lobe is higher and better acceptable for adults, while the left lobe is smaller and higher suitable for children.
The diseased liver is opened up and is removed. Then the part of the liver taken from the donor is replaced making the connections in bile ducts and blood vessels as in an Orthotopic transplant.
Following transplants, the transplanted lobe will shortly regenerate itself. Even for the donor, the removed part of the liver grows back. In the recipient, the new lobe normally grows up to 85% of the original liver size within a week.
The concept of LDLT is depended on
- The widespread shortage of cadaveric liver for patients awaiting transplant.
- The remarkable regenerative capacities of the human liver.
Orthotopic transplant from a recently deceased donor
An orthotopic transplant is the most common kind of liver transplant. The total liver replaced from the recently deceased donor.
For the surgical operation, the health care provider makes an incision over the stomach and eliminates the diseased liver. The donor liver will then be put in a role and all the blood vessels and bile ducts would be connected. The incision is then closed with dissolvable stitches or surgical staples.
Split type of liver transplant
Split type of liver transplant involves transplantation of a liver from a deceased individual to two recipients. The donated liver is suitable for an adult and a child. The liver will split into right and left lobes. The child will receive the smaller left lobe and adult normally receives the larger right lobe.
This type of liver transplant benefits for two persons at a time. The transplanted liver grow back to the original size by regeneration.
Requirements for Liver donor
Any member of the parent, family, sibling, or a volunteer can donate their liver to diseased person. The criteria for a liver donation include:
- Want to be in good health
- Age between 18 and 55 years old
- Being of bigger size than the recipient
- Blood group must similar to patient
- Being a Living donor must testing to ensure that the individual in physically fit.
Why Liver transplant is Required ?
Hepatocellular carcinoma and cirrhosis are the treatment of end stage liver disease. It often attributable to one or more of the following:
- Long-term untreated hepatitis C infection
- Long-term untreated hepatitis B infection
- Long-term Alcohol abuse
Acute Liver failure:
Acute liver failure occurs when a previously healthy liver suffers a massive injury resulting in clinical and then the symptoms of acute liver failure is insufficiency. It also called Fulminant hepatic failure. Any number of things can lead to acute liver failure. The most common causes are viral infections, acetaminophen overdose, and ingestion of a toxin.
The ingestion of a toxin such as
- Idiosyncratic drug reaction
- Poisonous mushrooms
The acute disease may die within days if they not transplanted but chronic liver failure, who can survive weeks to years while waiting for liver transplant.
Chronic liver failure:
The end stage of scarring is termed as cirrhosis. It corresponds to the point where the liver can no longer repair itself. This chronic liver has a remarkable ability to repair itself in response to injury.
Causes of Chronic failure
- Viral Hepatitis
- Alcoholic Liver Disease
- Metabolic Liver Disease
- Autoimmune Liver Disease
- Genetic Liver Disease
- Vascular Liver Disease
- Hepatocellular Carcinoma
Who Are Not Candidates for a Liver Transplant:
There are many peoples with decompensated and cirrhosis liver disease but not all are appropriate candidates for liver transplant. A Diseased person must able to survive the operation and the post-operative complications, take the medications that prevent the rejection and opportunistic infections, comply with frequent laboratory tests, and clinic visit. Not engage in activity that would injure the liver, like drinking alcohol.
The condition below are considered to be absolute indications to liver transplantation:
- Uncontrollable or systemic infection
- Pulmonary artery pressure greater than 50mmhg
- Irreversible, severe medical illness that limits short-term expectancy
- Cancer that has spread outside of the liver
- Active substance abuse (alcohol)
- Unacceptable risk for substance abuse
- History of inability to adhere to a strict medical regimen
- Uncontrolled psychiatric disease
Overall, consequences for liver transplantation are very good, however, range significantly depending on the indication for liver transplant as well as elements associated with the donor. Currently, the normal patient survival one 12 months after liver transplant is 88%. Patient survival five years after liver transplant is 73%.
As noted above, these outcomes vary extensively based on the indication for liver transplantation. For example, sufferers who underwent transplantation for hepatocellular carcinoma had a one-year survival of only 86% whereas sufferers who underwent transplantation for biliary atresia liver disorder had a one-year survival of 94%. The encouraging trend is that over the previous 20 years short and long-term affected person survival has continued to improve. With advances in surgical technique, organ preservation, peri-operative care, and immunosuppression, survival will hopefully proceed to improve in the future.
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